咽旁间隙多形性腺瘤与神经鞘瘤的影像鉴别诊断  

CT and MRI Differential Diagnosis of Pleomorphic Adenomas and Neurilemmomas in the Parapharyngeal Space

作　　者：吴芹[1] 陈燕萍[1] 徐嬿[1] 刘彩霞[1] 

机构地区：[1]南方医科大学附属南方医院影像中心,广州510515

出　　处：《临床放射学杂志》2011年第8期1116-1119,共4页Journal of Clinical Radiology

摘　　要：目的探讨咽旁间隙多形性腺瘤与神经鞘瘤的CT与MRI表现,旨在提高对两者的鉴别诊断水平。资料与方法回顾性分析经临床手术病理证实的13例咽旁间隙多形性腺瘤与8例神经鞘瘤患者的CT与MRI表现,重点观察病变所在位置、与周围组织的关系及占位效应。结果 21例咽旁间隙肿块均边界光滑,包膜完整,可见坏死囊变区,体积多较大(最长径多>4 cm),占位效应明显。其中13例多形性腺瘤均来源于腮腺深叶,突向咽旁间隙生长,同侧咽旁间隙受压变窄,向内移位,呈裂隙状位于肿块的内前方,茎突受压向内后方移位。8例神经鞘瘤,肿块与腮腺深叶分界清楚,可见脂肪间隙。结论生长在咽旁间隙的多形性腺瘤与神经鞘瘤的鉴别诊断较难,鉴别诊断需依靠肿块所在位置、与腮腺的关系及其周围结构如咽旁间隙脂肪和茎突的移位情况进行综合分析。Objective To analyze the CT and MRI appearances of pleomorphic adenomas and neurilemmomas in the parapharyngeal space（pps）,and to improve the differential diagnosis between them.Materials and Methods Thirteen cases of pleomorphic adenomas and 8 cases of neurilemmomas in the pps were collected in the study.The lesion＇s position,the relationship with the surrounding tissue and mass effects were analyzed retrospectively.All of them were scanned with CT and/or MRI and then confirmed pathologically.Results All the 21 lesions demonstrated clear margin and complete capsule.The masses showed large size（mostly the diameters were 4cm）,with necrotic or cystic areas and significant mass effects.Pleomorphic adenomas arised from deep-lobe of parotid glands and grew to the ipsilateral pps,the pps was compressed and shifted forward and interiorly.There were clear boundaries and visible fat space between neurilemmomas and deep-lobe of parotid glands.Conclusion Differential diagnosis of pleomorphic adenomas and neurilemmomas in the pps depend upon the location of tumors,the relationship between the lesions and surrounding structures and mass effects.

关 键 词：咽旁间隙多形性腺瘤神经鞘瘤体层摄影术 X线计算机磁共振成像 

分 类 号：R766[医药卫生—耳鼻咽喉科] R739.4[医药卫生—临床医学]